Environmental exposure to active pharmaceutical ingredients (APIs) can have negative effects on the health of ecosystems and humans. While numerous studies have monitored APIs in rivers, these employ different analytical methods, measure different APIs, and have ignored many of the countries of the world. This makes it difficult to quantify the scale of the problem from a global perspective. Furthermore, comparison of the existing data, generated for different studies/regions/continents, is challenging due to the vast differences between the analytical methodologies employed. Here, we present a global-scale study of API pollution in 258 of the world’s rivers, representing the environmental influence of 471.4 million people across 137 geographic regions. Samples were obtained from 1,052 locations in 104 countries (representing all continents and 36 countries not previously studied for API contamination) and analyzed for 61 APIs. Highest cumulative API concentrations were observed in sub-Saharan Africa, south Asia, and South America. The most contaminated sites were in low- to middle-income countries and were associated with areas with poor wastewater and waste management infrastructure and pharmaceutical manufacturing. The most frequently detected APIs were carbamazepine, metformin, and caffeine (a compound also arising from lifestyle use), which were detected at over half of the sites monitored. Concentrations of at least one API at 25.7% of the sampling sites were greater than concentrations considered safe for aquatic organisms, or which are of concern in terms of selection for antimicrobial resistance. Therefore, pharmaceutical pollution poses a global threat to environmental and human health, as well as to delivery of the United Nations Sustainable Development Goals.

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Food safety is a global issue, affecting food production and processing. The study assessed the microbiological quality of commercially dried fruits and home dried fruits and vegetables in Lesotho. Moisture content, pH and water activity of the fruits and vegetables were determined using standard methods. Nine different growth media were used for microbial evaluation. Moisture content and water activity were within World Health Organisation guidelines for dried fruits and vegetables. Fungi counts ranged from 2.0x10 2 to 8.7x10 5 CFU g -1, and dried pumpkin leaves recorded the highest. More than 45% and 38% of the samples exceeded the fungal and total aerobic counts recommended by WHO, respectively. Possible pathogens of the genera Salmonella, Shigella, Bacillus and other Enterobacteriaceae were isolated from home dried samples. Faecal coliforms were detected in 55% of the home dried food products. More than 60% of the samples recorded higher microbial levels than recommended. While half of commercially dried fruits exceeded international standards, all home dried fruits and vegetables recorded unacceptably high levels of fungal contamination. The presence of possible pathogenic organisms in these foodstuffs suggest a potential public health hazard to consumers. Sanitation and personal hygiene, especially during home-based food processing, needs improvement.

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The southern African country of Lesotho introduced an old age pension scheme in 2004 with the aim of enhancing the quality of life (QoL) of the nation's elderly population. This study is the first to assess the physical, psychological, social, and environmental aspects of the health-related QoL of the elderly in Lesotho since the pension scheme was adopted. Data for this study were gathered using the World Health Organization QoL-BREF questionnaire. Mean QoL scores were compared across demographic, socioeconomic, and clinical variables using analysis of variance, t test, and regression analysis. Findings indicate that respondents were least satisfied with the environmental and physical domains of QoL. They also indicate that the overall QoL of the elderly in Lesotho was mainly affected by marital status, level of education, type of housing, source of income, and level of satisfaction with income. These factors should thus be taken into account when developing interventions aimed at improving the QoL of the elderly in Lesotho.

Background: Plants are important sources of medicines. Herbal medicines in Lesotho are exposed to excessive exploitation and habitat destruction. Comprehensive information to promote proper use and conservation of these herbal medicines is lacking. This study described the uses of medicinal plants in Lesotho with comparative reference between practice and the literature, highlighting important ethno-medicinal information and conservation status of the plants. Additionally, the study established a repository and monograph for the herbal medicines in Lesotho. Materials and Methods:Medicinal plant samples and information on their uses were obtained from herbalists in four districts of Lesotho between January and May 2014 through questionnaire-based interviews. Samples consisted of roots, bark, stems or leaves and/or combinations. Voucher samples were processed into powders, labelled, and stored in a repository. Information on the uses, plant parts used, geographical distribution, known phytochemical components and conservation status of each plant was recorded in a Microsoft Access database. Results: Seventy-eight local herbalists were interviewed and men (about 84%) dominated the practice of traditional medicine. Fifty-four herbal medicine samples were collected and stored in a recently established Lesotho Herbal Medicines Repository (LHMR). The herbal medicines were from 54 medicinal plant species and 46 genera belonging to 29 plant families. Asteraceae (about 20%) was the most common plant family. Overall, 46% (n=54) of the prescriptions by local herbalists were similar to prescriptions in the literature at least in part. However, traditional medicinal uses for 9% of the plant samples could not be confirmed from the literature. Local herbalists use different parts of medicinal plants with roots being the most frequently (57%) used part. Twenty percent of the plants were threatened with extinction while the conservation status of 7% of the plants was undocumented. Conclusion: Training of local herbalists on sustainable harvesting and safe use of medicinal plants is recommended. The repository and monograph is a useful reference and source of herbal medicine samples for researchers, which need to be expanded to include more medicinal plants in Lesotho. Local herbalists in Lesotho have valuable indigenous information on medicinal plants that needs to be documented.

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